The Pain of Labour

Abstract

Labour is an emotional experience and involves both physiological and psychological mechanisms.The pain of labour is severe but despite this its memory diminishes with time.Labour pain has two components: visceral pain which occurs during the early first stage and the second stage of childbirth, and somatic pain which occurs during the late first stage and the second stage.The pain of labour in the first stage is mediated by T10 to L1 spinal segments, whereas that in the second stage is carried by T12 to L1, and S2 to S4 spinal segments.Pain relief in labour is complex and often challenging without regional analgesia.Effective management of labour pain plays a relatively minor role in a woman's satisfaction with childbirth.

Labor pain in women with and without severe fear of childbirth: A population‐based, longitudinal study

“…Empirical reports on the effect of anesthetics provide mixed results where some studies report-in line with our findings-that use of anesthetics is related to higher pain scores, 22,25 whereas other studies report a reduction in overall pain, especially when using the epidural block. 46,48 Finally, the experience of prepregnancy menstrual pain affected the association between severe fear of childbirth and labor pain. 41,42 On the other hand, higher ratings could be because women who experience more pain during labor usually receive more anesthetics or also may be because of feeling the need to justify the use of the anesthetics.…”

Labor Pain: Perception of the Parturient and Midwife Evaluation

“…The subject is controversial, because on the one hand actual results contribute to some studies [19], deny those who observe greater pain in nulliparous [7,8] or otherwise in multiparous [6]. There are physical reasons for the nulliparous has more pain in the 1 st phase of the labor as dilation and fetal descent, for greater capacity of the uterine fibers takes place in early process.…”

“…In multiparous, saves up high fetus during the 1 st phase of the labor and in these circumstances the fall in the 2 nd phase (i.e. pelvic phase) is more abrupt and rapid, intensely stimulates the nociceptors of the perineum and vulva making the perception of pain higher compared to nulliparous [8]. However, parity is not the major aspect in pain severity perception.…”

“…Show some authors that the level of pain is labeled as much more painful than expected. In nulliparous women the expectation of pain prior to birth, is often underestimated [5] and the highest pain both observed in multiparous [6] and in nulliparous [7,8]. Also despite the prenatal class frequency, recall the pain is referred to the extremes, both bearable as excruciating [6,8].…”

“…However, the pain of labor is real, it is one of the main fears of parturient, and one of the main challenges of midwives assisting in a delivery. Although the memory of labor pain is typically lessened over time [8] and this leads to interest in knowing specifically the level of pain, the immediacy of the event.…”